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Gas & bloating: Is it a real problem or are you just full of hot air?

Some of the most common gastrointestinal complaints have to do with excessive gas. Problems with gas come in several forms including abdominal bloating, frequent burping and excessive flatus. These issues can be quite bothersome and distressing. In this article we review some potential causes of these common problems and suggest potential solutions.

Battle of the bulge

Bloating is the subjective sensation of abdominal fullness. This is distinguished from abdominal distension which is an objective, measureable increase in abdominal girth. As mentioned above, if either of these issues arise abruptly they should prompt an investigation to exclude any worrisome problems. Having said that, the most common causes of abdominal bloating have to do how the gastrointestinal tract handles its contents – namely gas, fluids and stool. Gas accumulates in the intestinal tract from swallowed air or from gas-producing bacteria. Some foods (such as beans, broccoli, dairy products, artificial sweeteners, etc) produce a lot of intestinal gas. Avoiding these foods may alleviate bloating. Similarly, fluid accumulation in the bowel can result from dietary intake of certain non-absorbable foods, intestinal disorders that interfere with proper digestion, a bacterial imbalance in the bowel, or other conditions. Teasing out the exact source is often difficult and an evaluation by your doctor may be helpful. Finally, chronic constipation can lead to bloating and distension due to accumulation of solid waste in the colon. Having regular bowel movements, potentially with the aid of laxative medications, is often effective in relieving symptoms of bloating and distension.  

Trouble down below

Flatulence results from excessive gas in the colon. The most common cause of intestinal gas accumulating in the colon is the breakdown of undigested food, such as plant fiber, by intestinal bacteria. This may result from a diet high in various fiber-rich foods, intestinal disorders that cause malabsorption or dysmotility in the bowel, chronic constipation or disturbances in the colonic bacterial flora. The majority of cases of excessive flatus can be managed by altering the diet to exclude specific foods associated with gas production. If dietary interventions fail to solve the problems a consultation with a doctor may be helpful.

Trouble up above

Belching or burping is the way the body expels excess swallowed air from the stomach. People may swallow excess air by eating too quickly, chewing gum, drinking carbonated beverages or smoking. In addition, acid reflux (or GERD) can induce excessive air swallowing as the esophagus tries to clear acid that regurgitates from the stomach. Excessive belching can be reduced by eating more slowly, avoiding carbonated beverages, not chewing gum, quitting smoking, and treating uncontrolled acid reflux. If these simple measures are ineffective a consultation with a doctor may help.

Don’t assume it’s “just gas”

Finally, and most importantly, you should not assume that bloating is just bloating or that gas is just gas. If your belly doubles in size unexpectedly or other new symptoms suddenly arise they should be investigated. This is because abdominal symptoms can result from not only gas but also accumulation of fluid, development of a mass, or other worrisome issues. Consult your doctor for a thorough evaluation of any unexplained new symptoms.

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